1
|
Peikert K, Danek A, Hermann A. Current state of knowledge in Chorea-Acanthocytosis as core Neuroacanthocytosis syndrome. Eur J Med Genet 2018; 61:699-705. [DOI: 10.1016/j.ejmg.2017.12.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 12/01/2017] [Accepted: 12/14/2017] [Indexed: 11/30/2022]
|
2
|
Walker RH. Untangling the Thorns: Advances in the Neuroacanthocytosis Syndromes. J Mov Disord 2015; 8:41-54. [PMID: 26090076 PMCID: PMC4460540 DOI: 10.14802/jmd.15009] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 12/25/2022] Open
Abstract
There have been significant advances in neuroacanthocytosis (NA) syndromes in the past 20 years, however, confusion still exists regarding the precise nature of these disorders and the correct nomenclature. This article seeks to clarify these issues and to summarise the recent literature in the field. The four key NA syndromes are described here-chorea-acanthocytosis, McLeod syndrome, Huntington's disease-like 2, and pantothenate kinase- associated neurodegeneration. In the first two, acanthocytosis is a frequent, although not invariable, finding; in the second two, it occurs in approximately 10% of patients. Degeneration affecting the basal ganglia is the key neuropathologic finding, thus the clinical presentations can be remarkably similar. The characteristic phenotype comprises a variety of movement disorders, including chorea, dystonia, and parkinsonism, and also psychiatric and cognitive symptoms attributable to basal ganglia dysfunction. The age of onset, inheritance patterns, and ethnic background differ in each condition, providing diagnostic clues. Other investigations, including routine blood testing and neuroimaging can be informative. Genetic diagnosis, if available, provides a definitive diagnosis, and is important for genetic counseling, and hopefully molecular therapies in the future. In this article I provide a historical perspective on each NA syndrome. The first 3 disorders, chorea-acanthocytosis, McLeod syndrome, Huntington's disease-like 2, are discussed in detail, with a comprehensive review of the literature to date for each, while pantothenate kinase-associated neurodegeneration is presented in summary, as this disorder has recently been reviewed in this journal. Therapy for all of these diseases is, at present, purely symptomatic.
Collapse
Affiliation(s)
- Ruth H. Walker
- Department of Neurology, James J. Peters Veterans Affairs Medical Center, Bronx, NY, USA
- Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA
| |
Collapse
|
3
|
Abnormal red cell features associated with hereditary neurodegenerative disorders: the neuroacanthocytosis syndromes. Curr Opin Hematol 2015; 21:201-9. [PMID: 24626044 DOI: 10.1097/moh.0000000000000035] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW This review discusses the mechanisms involved in the generation of thorny red blood cells (RBCs), known as acanthocytes, in patients with neuroacanthocytosis, a heterogenous group of neurodegenerative hereditary disorders that include chorea-acanthocytosis (ChAc) and McLeod syndrome (MLS). RECENT FINDINGS Although molecular defects associated with neuroacanthocytosis have been identified recently, their pathophysiology and the related RBC abnormalities are largely unknown. Studies in ChAc RBCs have shown an altered association between the cytoskeleton and the integral membrane protein compartment in the absence of major changes in RBC membrane composition. In ChAc RBCs, abnormal Lyn kinase activation in a Syk-independent fashion has been reported recently, resulting in increased band 3 tyrosine phosphorylation and perturbation of the stability of the multiprotein band 3-based complexes bridging the membrane to the spectrin-based membrane skeleton. Similarly, in MLS, the absence of XK-protein, which is associated with the spectrin-actin-4.1 junctional complex, is associated with an abnormal membrane protein phosphorylation state, with destabilization of the membrane skeletal network resulting in generation of acanthocytes. SUMMARY A novel mechanism in generation of acanthocytes involving abnormal Lyn activation, identified in ChAc, expands the acanthocytosis phenomenon toward protein-protein interactions, controlled by phosphorylation-related abnormal signaling.
Collapse
|
4
|
Moghimi N, Jabbari B, Szekely AM. Primary dystonias and genetic disorders with dystonia as clinical feature of the disease. Eur J Paediatr Neurol 2014; 18:79-105. [PMID: 23911094 DOI: 10.1016/j.ejpn.2013.05.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 05/14/2013] [Indexed: 12/19/2022]
Abstract
Dystonia is probably the most common form of movement disorder encountered in the clinical practice. It is characterized by sustained muscle contractions, usually producing twisting and repetitive movements or abnormal postures or positions. Dystonias can be classified in several ways, including primarily by the clinical phenomenology or by the underlining etiology, in particular to understand if the presentation is genetically determined. By advances of genetics, including contemporary genomic technologies, there is a growing understanding of the molecular underpinnings of genetically determined dystonias. The intricacy of information requires a user friendly, novel database that may efficiently serve clinicians to inform of advances of the field and to diagnose and manage these often complex cases. Here we present an up to date, comprehensive review - in tabulated formats - of genetically determined primary dystonias and complex Mendelian disorders with dystonia as central feature. The detailed search up to December 24, 2012, identified 24 hereditary primary dystonias (DYT1 to DYT 25) that are mostly monogenic disorders, and a larger group (>70) of genetic syndromes in which dystonia is one of the characteristic clinical features. We organized the findings not only by individual information (name of the conditions, pattern of inheritance, chromosome and gene abnormality, clinical features, relevant ancillary tests and key references), but also provide symptom-oriented organization of the clinical entities for efficient inquiries.
Collapse
Affiliation(s)
- Narges Moghimi
- Epilepsy and Clinical Neurophysiology Section, Department of Neurology, University Hospital, Case Western University School of Medicine, Cleveland, OH, United States
| | - Bahman Jabbari
- Department of Neurology, Yale University School of Medicine, New Haven, CT, United States
| | - Anna M Szekely
- Department of Genetics, Yale University School of Medicine, New Haven, CT, United States; Department of Neurology, Yale University School of Medicine, New Haven, CT, United States.
| |
Collapse
|
5
|
Shah JR, Patkar DP, Kamat RN. A case of McLeod phenotype of neuroacanthocytosis brain MR features and literature review. Neuroradiol J 2013; 26:21-6. [PMID: 23859162 DOI: 10.1177/197140091302600103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 12/22/2012] [Indexed: 11/15/2022] Open
Abstract
Huntington's disease and neuroacanthocytosis may present similar clinical and MRI features. It is important to differentiate these findings since treatment and prognosis vary vastly between them. The aim of this article is to familiarize radiologists with the differentiating features of Huntington's disease and various diseases comprising neuroacanthocytosis. A 40-year-old Indian man with extrapyramidal symptoms was referred for MRI. The clinical diagnosis was Huntington's disease, but there were a few atypical clinical features such as a history of biting the tongue, tics, marked hyporeflexia and lower limb muscle wasting. MR showed atrophy of the caudate nucleus and putamen with iron deposition in the basal ganglia, which can be seen in Huntington's disease and in neuroacanthocytosis. An increased blood acanthocyte level was subsequently confirmed. Further work-up revealed increased serum creatine phosphokinase levels, normal serum lipoprotein levels and depressed K cell antigen activity on serological studies, confirming the diagnosis of McLeod syndrome. McLeod syndrome is one of the distinct phenotypes of neuroacanthocytosis. Neuroacanthocytosis is a group of disorders with increased serum acanthocyte counts and neurological involvement. Various causes of neuroacanthocytosis are discussed. It is important to consider the possibility of neuroacanthocytosis when features typical of Huntington's disease are encountered on imaging.
Collapse
Affiliation(s)
- J R Shah
- Gokuldas Tejpal Hospital Spectrum CT MRI Centre, Mumbai, India.
| | | | | |
Collapse
|
6
|
Zhang L, Wang S, Lin J. Clinical and molecular research of neuroacanthocytosis. Neural Regen Res 2013; 8:833-42. [PMID: 25206731 PMCID: PMC4146083 DOI: 10.3969/j.issn.1673-5374.2013.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2012] [Accepted: 12/23/2012] [Indexed: 11/18/2022] Open
Abstract
Neuroacanthocytosis is an autosomal recessive or dominant inherited disease characterized by widespread, non-specific nervous system symptoms, or spiculated "acanthocytic" red blood cells. The clinical manifestations typically involve chorea and dystonia, or a range of other movement disorders. Psychiatric and cognitive symptoms may also be present. The two core neuroacanthocytosis syndromes, in which acanthocytosis is atypical, are autosomal recessive chorea-acanthocytosis and X-linked McLeod syndrome. Acanthocytes are found in a smaller proportion of patients with Huntington's disease-like 2 and pantothenate kinase-associated neurodegeneration. Because the clinical manifestations are diverse and complicated, in this review we present features of inheritance, age of onset, neuroimaging and laboratory findings, as well as the spectrum of central and peripheral neurological abnormalities and extraneuronal involvement to help distinguish the four specific syndromes.
Collapse
Affiliation(s)
- Lihong Zhang
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian 116033, Liaoning Province, China
| | - Suping Wang
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian 116033, Liaoning Province, China
| | - Jianwen Lin
- Department of Neurology, Dalian Municipal Central Hospital, Affiliated Hospital of Dalian Medical University, Dalian 116033, Liaoning Province, China
| |
Collapse
|
7
|
Aasly J, Sando S, Undeland M, Waage A. [A young woman with adverse effects of neuroleptics]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2009; 129:33-5. [PMID: 19174851 DOI: 10.4045/tidsskr.2009.18530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
|
8
|
Neuroacanthocytosis. NEURODEGENER DIS 2005. [DOI: 10.1017/cbo9780511544873.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
9
|
Danek A, Jung HH, Melone MAB, Rampoldi L, Broccoli V, Walker RH. Neuroacanthocytosis: new developments in a neglected group of dementing disorders. J Neurol Sci 2005; 229-230:171-86. [PMID: 15760637 DOI: 10.1016/j.jns.2004.11.024] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Neurological abnormalities associated with spiculated, "acanthocytic" red cells in blood have been summarized as neuroacanthocytosis. This is a heterogeneous group of conditions that can now be clearly subdivided on the basis of genetic discoveries. The core neuroacanthocytosis syndromes are autosomal recessive chorea-acanthocytosis (ChAc) and the X-linked McLeod syndrome (MLS). Huntington's disease-like 2 (HLD2) and pantothenate kinase associated neurodegeneration (PKAN) can now also be included. All of these share dyskinesias, cognitive deterioration and progressive neurodegeneration mainly of the basal ganglia, but they are sufficiently distinct to permit a specific working diagnosis on the basis of clinical, laboratory and imaging findings. In addition, the VPS13A (formerly called CHAC), XK, JPH3 and PANK2 genes, respectively, may be examined for mutations. Unfortunately, little is yet known about the normal and abnormal physiology of the protein products of these genes, but they appear to be involved in membrane function and intracellular protein sorting. Since no cures are yet available, development and study of disease models in experimental animals (mouse, C. elegans) is a priority for current research. From a clinical point of view, the common occurrence of cardiomyopathy in MLS, the transfusion hazards due to the McLeod Kell phenotype and the possibility of improving the violent trunk spasms and orofacial dyskinesias typical for ChAc (with subsequent lip or tongue mutilations and feeding dystonia) by deep brain surgery or stimulation should be considered in patient management.
Collapse
Affiliation(s)
- Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität Marchioninistr. 15 D-81366 Munich, Germany.
| | | | | | | | | | | |
Collapse
|
10
|
Aasly J, Skandsen T, Rø M. Neuroacanthocytosis--the variability of presenting symptoms in two siblings. Acta Neurol Scand 1999; 100:322-5. [PMID: 10536920 DOI: 10.1111/j.1600-0404.1999.tb00404.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neuroacanthocytosis is a progressive multisystem disease with a wide range of symptoms. The involuntary movements mainly include chorea and orofaciolingual dyskinesias. The descriptive name of the disease refers to the presence of abnormal erythrocytes in peripheral blood. Two siblings are presented. One young female had dystonia, self-mutilating behaviour, lip biting and eating difficulties. Her brother had repeated generalized epileptic seizures several years before developing choreatic movements and neuropsychiatric symptoms. Both had clinical signs of sensorimotor axonal polyneuropathy. Fresh blood smears in each patient contained between 15 and 20% acanthocytes compared to less than 2% in normal controls. Neuroacanthocytosis must be kept in mind in young adult patients without heredity for Huntington's disease and the diagnosis is easily confirmed when making a fresh blood smear.
Collapse
Affiliation(s)
- J Aasly
- Department of Neurology, University Hospital, Trondheim, Norway
| | | | | |
Collapse
|
11
|
Kutcher JS, Kahn MJ, Andersson HC, Foundas AL. Neuroacanthocytosis masquerading as Huntington's disease: CT/MRI findings. J Neuroimaging 1999; 9:187-9. [PMID: 10436764 DOI: 10.1111/jon199993187] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Neuroacanthocytosis (NA) is a rare, degenerative, presumably autosomal-recessive disorder of the nervous system presenting in adulthood and is associated with acanthocytosis of the peripheral blood. The clinical spectrum of NA shares similarities with Huntington's disease (HD), including dyskinetic choreiform movements and degeneration of the caudate nucleus. A woman presented with choreiform movements and was given a presumed diagnosis of HD. Neuroimaging studies were consistent with HD. She lacked the genetic marker for HD, and further evaluation revealed acanthocytosis of the peripheral blood. The case illustrates the similarities and differences in the clinical presentations and neuroimaging studies of these two disease entities, emphasizing the need for a careful clinical evaluation.
Collapse
Affiliation(s)
- J S Kutcher
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | | | | | | |
Collapse
|
12
|
Hirayama M, Hamano T, Shiratori M, Mutoh T, Kumano T, Aita T, Kuriyama M. Chorea-acanthocytosis with polyclonal antibodies to ganglioside GM1. J Neurol Sci 1997; 151:23-4. [PMID: 9335005 DOI: 10.1016/s0022-510x(97)00072-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A patient with chorea-acanthocytosis presenting with axonal neuropathy showed an elevation in IgM polyclonal antibodies to the GM1 ganglioside, which were estimated by enzyme-linked immunosorbent assay and complement-mediated liposome immune lysis assay (LILA). This is the first demonstration of such antibodies in chorea-acanthocytosis. Anti-GM1 antibodies might have directly caused the axonal neuropathy by binding to GM1 or cross-reactive antigens in the nerves.
Collapse
Affiliation(s)
- M Hirayama
- Second Department of Internal Medicine, Fukui Medical School, Japan
| | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
The putative relationship between a variety of neurologic and neuropsychiatric disorders, which have been reported in association with tics, is reviewed. Tics also may be increased or exacerbated by drugs affecting a variety of neurotransmitter systems. Recognition and study of these secondary tic disorders may further our understanding of basal ganglia physiology and the pathogenesis of Tourette syndrome.
Collapse
Affiliation(s)
- R Kumar
- Morton and Gloria Shulman Movement Disorders Centre, Division of Neurology, Department of Medicine, the Toronto Hospital, University of Toronto, Toronto, Ontario, Canada
| | | |
Collapse
|
14
|
Kazis A, Kimiskidis V, Georgiadis G, Voloudaki E. Neuroacanthocytosis presenting with epilepsy. J Neurol 1995; 242:415-7. [PMID: 7561972 DOI: 10.1007/bf00868399] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
15
|
Malandrini A, Fabrizi GM, Palmeri S, Ciacci G, Salvadori C, Berti G, Bucalossi A, Federico A, Guazzi GC. Choreo-acanthocytosis like phenotype without acanthocytes: clinicopathological case report. A contribution to the knowledge of the functional pathology of the caudate nucleus. Acta Neuropathol 1993; 86:651-8. [PMID: 8310821 DOI: 10.1007/bf00294306] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Detailed clinical and neuropathological findings in two unrelated patients with a chorea-acanthocytosis-like phenotype (CA) are reported. One case met all the diagnostic criteria of CA and had a deceased brother with the same disease. The second case had a virtually identical phenotype to the former but without acanthocytes. These findings suggest that both patients are affected by the same disease and that acanthocytes are not essential to the diagnosis. Neuropathological autopsy studies on the brain of the second case showed selective atrophy of the caudate nucleus that seemed to correspond to the movement disorder and behavioural abnormalities prominent in this patient. In both subjects, morphometric and ultrastructural examination of the peripheral nerve showed loss of myelinated fibres, more accentuated distally, and cytoskeletal changes in the axoplasm. These findings support the hypothesis that peripheral neuropathy in CA is caused by distal axonopathy.
Collapse
Affiliation(s)
- A Malandrini
- Institute for Neurological Sciences, University of Siena, Italy
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Schwartz MS, Monro PS, Leigh PN. Epilepsy as the presenting feature of neuroacanthocytosis in siblings. J Neurol 1992; 239:261-2. [PMID: 1607887 DOI: 10.1007/bf00810348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A brother and sister developed epilepsy at the age of 28 and 30 years respectively, and were subsequently found to have neuroacanthocytosis. The brother developed tics, and a tendency to self-mutilate a year later, but his sister had not developed any movement disorder in the 5 years since the onset of epilepsy. In families with epilepsy, the diagnosis of neuroacanthocytosis should be considered, particularly when one family member has tics or other involuntary movements.
Collapse
Affiliation(s)
- M S Schwartz
- Department of Neurology, Atkinson Morley's Hospital, London, UK
| | | | | |
Collapse
|
17
|
Boivin P. [Homologies between membrane proteins result in expected or unexpected relations between neuromuscular and erythrocyte diseases]. Rev Med Interne 1992; 13:156-61. [PMID: 1410892 DOI: 10.1016/s0248-8663(05)82202-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The advances achieved in biochemistry and molecular genetics have made it possible to demonstrate that the membrane proteins of the erythrocytes belong to protein "families" that are present in most cell membranes and share remarkable structural and functional homologies. Abnormalities of erythrocyte membrane proteins might then totally or partially reflect lesions of other cell membranes that are intrinsically more severe than those of the erythrocytes. Examples of these physiopathogenetic links can be found in congenital diseases where muscular and erythrocytic pathologies coexist. Such are: (1) choreaacanthocytosis supported by molecular abnormalities of the so-called band 3 protein or anion channel; (2) Mac Leod syndrome by deficiency of a membrane protein precursor of Kell antigens; (3) some cases of hereditary spherocytosis associated with qualitative and quantitative ankyrin alterations. Yet, despite the homologies that are known to exist between spectrin and dystrophin, all attempts to use spectrin analysis as marker of Duchenne-Becker muscular dystrophy have met with complete failure, which shows that at this early stage one should refrain from drawing firm physiopathological conclusions from the available data.
Collapse
Affiliation(s)
- P Boivin
- INSERM U 160, Hôpital Beaujon, Clichy
| |
Collapse
|
18
|
Sakai T, Antoku Y, Iwashita H, Goto I, Nagamatsu K, Shii H. Chorea-acanthocytosis: abnormal composition of covalently bound fatty acids of erythrocyte membrane proteins. Ann Neurol 1991; 29:664-9. [PMID: 1832532 DOI: 10.1002/ana.410290615] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Phospholipid class, peak profile of each phospholipid class, loosely bound fatty acids, covalently (tightly) bound fatty acids of the erythrocyte membranes, and plasma fatty acids were investigated using high-performance liquid chromatography in six patients with chorea-acanthocytosis and 14 age- and sex-matched normal control subjects. Additionally, six patients with Huntington's disease were included as disease control subjects in the study of covalently bound fatty acids. Study of covalently (tightly) bound fatty acids in erythrocyte membrane proteins after alkaline hydrolysis, hitherto undescribed in chorea-acanthocytosis, revealed that palmitic acid (C16:0) was significantly increased and stearic acid (C18:0) was decreased in the patients with chorea-acanthocytosis. Analyses for total covalently bound fatty acids disclosed that palmitic and docosahexaenoic (C22:6) acids were increased and stearic acid was decreased in chorea-acanthocytosis. Phospholipid class (phosphatidylcholine, phosphatidylethanolamine, sphingomyelin, and phosphatidylserine) and peak profile of each phospholipid class from the erythrocyte membranes did not differ between the patients with chorea-acanthocytosis and the control subjects. Of the loosely bound fatty acids, linoleic acid (C18:2) was significantly decreased in those with chorea-acanthocytosis, which seemed to be nonspecific.
Collapse
Affiliation(s)
- T Sakai
- Department of Neurology, National Chikugo Hospital, Fukuoka, Japan
| | | | | | | | | | | |
Collapse
|
19
|
Kay MM, Goodman J, Lawrence C, Bosman G. Membrane channel protein abnormalities and autoantibodies in neurological disease. Brain Res Bull 1990; 24:105-11. [PMID: 1690071 DOI: 10.1016/0361-9230(90)90293-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Immunological analogues of band 3, the anion transporter of the human erythrocyte, have been identified in all cells, including both isolated neurons and neurons of the central nervous system. We hypothesized that the anion channel is altered in neurological disease associated with choreiform movements because gamma-aminobutyric acid (GABA), the major inhibitory neurotransmitter in mammalian brain, binds to its receptor and opens an integral membrane chloride channel. In order to examine this hypothesis, we studied a family with a serious, progressive, genetic neurologic disorder with acanthocytosis (choreoacanthocytosis) that resembles Huntington's chorea. We selected choreoacanthocytosis because erythrocytes, which are readily obtained, are affected in this disease as well as the central nervous system. Biochemical studies of erythrocytes from the proposita, mother, and brother revealed that sulfate transport Vmax was increased, and glucose efflux was decreased. Erythrocytes exhibited immunological changes indicative of cellular aging/transporter damage. In addition, transporter reactive antibodies were present. This is the first evidence for abnormalities of membrane transport in this neurologic disorder.
Collapse
Affiliation(s)
- M M Kay
- Department of Medicine, Texas A & M University, College of Medicine, Temple 76504
| | | | | | | |
Collapse
|
20
|
Alonso ME, Teixeira F, Jimenez G, Escobar A. Chorea-acanthocytosis: report of a family and neuropathological study of two cases. Neurol Sci 1989; 16:426-31. [PMID: 2804805 DOI: 10.1017/s0317167100029516] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We report three siblings, offspring of normal consanguineous parents, with a progressive neurological illness that began in midlife and was characterized primarily by chorea and leading to death in the fourth decade. The proband had erythrocyte acanthocytosis with normal serum beta-lipoprotein. Biopsy of left gastrocnemius muscle showed neurogenic muscular atrophy. There was a decrease in the numbers of large myelinated axons of the sural nerve. Postmortem examination of two cases showed marked atrophy, neuronal loss and gliosis of the caudate nucleus and putamen. Autosomal recessive inheritance is likely in this family.
Collapse
Affiliation(s)
- M E Alonso
- Department of Genetics, National Institute of Neurology and Neurosurgery, Mexico, D.F
| | | | | | | |
Collapse
|
21
|
Abstract
This is the first report from India of a family of 4 sisters and 3 brothers in whom the proband showed a complete form of the choreo-acanthocytosis syndrome, whereas the 2 brothers who had died earlier of this disease had no examination of their blood. The apparently healthy members of this family also showed acanthocytosis, suggesting that this is a multisystem disorder affecting cell membranes.
Collapse
|
22
|
de Yebenes JG, Brin MF, Mena MA, De Felipe C, del Rio RM, Bazan E, Martinez A, Fahn S, Del Rio J, Vazquez A. Neurochemical findings in neuroacanthocytosis. Mov Disord 1988; 3:300-12. [PMID: 2905427 DOI: 10.1002/mds.870030404] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We performed a neurochemical study of the brain of two unrelated patients, living in different continents, with neuroacanthocytosis. The levels of monoamines and their metabolites, gamma-aminobutyric acid and substance P, were measured in several brain areas and the monoamine metabolites in cerebrospinal fluid. The binding of 3H-spiperone to striatal membranes and to lymphocytes was also measured. Both patients had a progressive neurological disorder with onset in the third decade of life and characterized by a complex movement disorder, epilepsy, muscular wasting, and changes in behavior. The movement disorder initially manifested with oromandibular dystonia and limb chorea, but at the time of death was characterized by a severe dystonic syndrome. The chemical changes were similar in the two patients. The most important neurochemical findings were a depletion of dopamine and its metabolites in most brain areas, most notably in the striatum, and elevation of norepinephrine levels in the putamen and globus pallidus. Substance P was markedly reduced in the striatum and substantia nigra. Our findings may provide clues to the neurochemical mechanisms underlying dystonia.
Collapse
Affiliation(s)
- J G de Yebenes
- Departamento de Investigacíon, Centro Ramon y Cajal, Madrid, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Vance JM, Pericak-Vance MA, Bowman MH, Payne CS, Fredane L, Siddique T, Roses AD, Massey EW. Chorea-acanthocytosis: a report of three new families and implications for genetic counselling. AMERICAN JOURNAL OF MEDICAL GENETICS 1987; 28:403-10. [PMID: 3322006 DOI: 10.1002/ajmg.1320280219] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Chorea-acanthocytosis (CHA) is a rare inherited neurologic disorder with peripheral red cell acanthocytes and normal serum lipoprotein levels. To date, 8 families with the disorder have been reported outside of Japan. We describe 4 patients in 3 families with CHA and review the clinical presentations in previous reports. In addition, we report magnetic resonance imaging scans in these patients. The pattern of inheritance in these families is most likely autosomal recessive. Obligate heterozygotes do not have acanthocytes on wet preparation under phase microscope. Two of 3 propositi were initially diagnosed as having Huntington chorea. Chorea-acanthocytosis is an important differential in the diagnosis of Huntington chorea and should be considered in families without a family history. The paucity of families with CHA reported to date may represent lack of recognition.
Collapse
Affiliation(s)
- J M Vance
- Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Sobue G, Mukai E, Fujii K, Mitsuma T, Takahashi A. Peripheral nerve involvement in familial chorea-acanthocytosis. J Neurol Sci 1986; 76:347-56. [PMID: 2947975 DOI: 10.1016/0022-510x(86)90180-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Myelinated fibers and neuronal cell bodies of the ventral spinal outflow and primary sensory neurons were histopathologically examined in a patient with familial chorea-acanthocytosis and age-matched controls. The patient exhibited a marked loss of large myelinated axons and their neuronal cell bodies in the ventral spinal outflow, while there was frequent occurrence of axonal sprouts. Large myelinated fibers in sensory afferents were also decreased in number. Segmental de- and remyelination was markedly increased in teased fiber preparations of both motor and sensory peripheral nerves.
Collapse
|
25
|
Asano K, Osawa Y, Yanagisawa N, Takahashi Y, Oshima M. Erythrocyte membrane abnormalities in patients with amyotrophic chorea with acanthocythosis. Part 2. Abnormal degradation of membrane proteins. J Neurol Sci 1985; 68:161-73. [PMID: 3159851 DOI: 10.1016/0022-510x(85)90097-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Bands 2.1, 3 and 4.2 of the erythrocyte membrane proteins in chorea-acanthocytosis are self-digested faster than those in normal controls. The junction between spectrin and band 3 protein at the cytoplasmic side of the patients' erythrocyte membranes may have some conformational defects. The conformational defects of the proteins may be responsible for the low fluidity in the interior of the patients' erythrocyte membranes. These basic molecular defects may be widespread in other extraneural cell membranes as well as in neuronal cell membranes.
Collapse
|
26
|
Oshima M, Osawa Y, Asano K, Saito T. Erythrocyte membrane abnormalities in patients with amyotrophic chorea with acanthocytosis. Part 1. Spin labeling studies and lipid analyses. J Neurol Sci 1985; 68:147-60. [PMID: 3159850 DOI: 10.1016/0022-510x(85)90096-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Low fluidity was observed in the erythrocyte membranes of familial chorea-acanthocytosis by spin labeling with 12NS. The high content of the saturated fatty acids support the finding of low fluidity. Other lipid contents (cholesterol and phospholipids) and the cholesterol/phospholipid ratio were within normal ranges. The sharp decrease in the parameter, (h0/h-1)1/2, suggests phase separation deep inside the patients' erythrocyte membrane matrix. This distortion of the membrane matrix may be caused by membrane components other than the lipid components.
Collapse
|
27
|
|
28
|
|
29
|
Limos LC, Ohnishi A, Sakai T, Fujii N, Goto I, Kuroiwa Y. "Myopathic" changes in chorea-acanthocytosis. Clinical and histopathological studies. J Neurol Sci 1982; 55:49-58. [PMID: 6213738 DOI: 10.1016/0022-510x(82)90169-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Four cases of chorea-acanthocytosis were studied with special reference to muscular changes. All the cases showed the clinical stigmata of oro-linguo-facial dyskinesia with tongue biting, mild neurogenic muscular involvement and acanthocytosis. Serum creatine kinase (CK) was persistently elevated, showing MM type isozyme predominance. Histopathological studies of the peroneus brevis muscle showed prominent small group atrophy, increase of small fibers on diameter analysis, frequent angulated fibers, and angulated fibers with increased acid phosphatase activity. These findings are compatible with chronic denervation. However, central nucleation (approximately 10%) and fiber splitting (2-8%) were also found in all cases. These are compatible with myopathic changes. No correlation of these "myopathic" changes and serum CK levels was found. The "myopathic" findings are probably secondary to chronic denervation.
Collapse
|
30
|
Ohnishi A, Sato Y, Nagara H, Sakai T, Iwashita H, Kuroiwa Y, Nakamura T, Shida K. Neurogenic muscular atrophy and low density of large myelinated fibres of sural nerve in chorea-acanthocytosis. J Neurol Neurosurg Psychiatry 1981; 44:645-8. [PMID: 7288454 PMCID: PMC491072 DOI: 10.1136/jnnp.44.7.645] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In three cases of chorea-acanthocytosis (acanthocytosis and neurological disease, or familial degeneration of the basal ganglia with acanthocytosis), biopsies of short peroneal muscles and sural nerves were studied histologically. The muscles showed groups of atrophic fibres with clumping of sarcolemmal nuclei in all cases. It was concluded that neurogenic muscular atrophy should be included as one of the main pathological findings in chorea-acanthocytosis. The sural nerves showed a small number of large myelinated fibres in two cases. This finding remains to be confirmed in other cases.
Collapse
|
31
|
Abstract
A patient is reported with hypobetalipoproteinaemia and clinical features resembling the Bassen-Kornzweig syndrome (abetalipoproteinaemia) more completely than previously described. This supports a link between hypobetalipoproteinaemia and abetalipoproteinaemia and it is suggested that the Bassen-Kornzweig syndrome has a wide spectrum with serum betalipoprotein ranging from absent to normal. It is likely that there are different genetic entities with similar end results.
Collapse
|
32
|
Bird TD, Cederbaum S, Valey RW, Stahl WL. Familial degeneration of the basal ganglia with acanthocytosis: a clinical, neuropathological, and neurochemical study. Ann Neurol 1978; 3:253-8. [PMID: 666266 DOI: 10.1002/ana.410030312] [Citation(s) in RCA: 69] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Three siblings, offspring of normal consanguineous parents, had a progressive neurological disorder characterized primarily by chorea and leading to death in the fourth or fifth decade. The most carefully studied patient had neither malabsorption nor absent serum beta-lipoprotein but did have erythrocyte acanthocytosis. Postmortem examination showed marked neuronal loss and gliosis of the caudate nucleus and putamen. Activities of glutamic acid decarboxylase and choline acetyltransferase were normal in cortex, caudate, and putamen. Autosomal recessive inheritance, acanthocytosis, and probable peripheral neuropathy help differentiate this disorder from Huntington's disease.
Collapse
|
33
|
|
34
|
Lantos PL, Aminoff MJ. Fine structural changes in the sural nerve of patients with acanthocytosis. Acta Neuropathol 1972; 22:257-63. [PMID: 4637007 DOI: 10.1007/bf00684528] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
35
|
Critchley E. Acanthocytosis associated with tics and involuntary movements. J Neurol 1971. [DOI: 10.1007/bf00316596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
36
|
Critchley EM, Nicholson JT, Betts JJ, Weatherall DJ. Acanthocytosis, normolipoproteinaemia and multiple tics. Postgrad Med J 1970; 46:698-701. [PMID: 5492702 PMCID: PMC2467126 DOI: 10.1136/pgmj.46.542.698] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
A chronic degenerative neurological disorder is described which is characterized by tics, grimacing, involuntary movements, a severe disturbance of swallowing and a concurrent malformation of the erythrocytes. This condition is clearly different from familial hypo-betalipoproteinaemia and abetalipoproteinaemia, the two previously described neurological disorders associated with abnormal red cells.
Collapse
|
37
|
|
38
|
Mars H, Lewis LA, Robertson AL, Butkus A, Williams GH. Familial hypo-beta-lipoproteinemia: a genetic disorder of lipid metabolism with nervous system involvement. Am J Med 1969; 46:886-900. [PMID: 4978919 DOI: 10.1016/0002-9343(69)90089-8] [Citation(s) in RCA: 84] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
39
|
|